Pain Management Flashcards Preview

Pharmacology (5th year) > Pain Management > Flashcards

Flashcards in Pain Management Deck (27):
1

2 major types of pain

- nociceptive
- neuropathic

2

Denifition of nociceptive pain

Normal pain processing that occurs when free nerve endings are activated by tissue damage or inflammation

3

4 processes of nociceptive pain

- transduction
- transmission
- perception
- modulation

4

Definition of neuropathic pain

Abnormal processing of stimuli from the PNS or CNS that serves no useful purpose

5

Types of pain assessment tools

- universal pain assessment tool
- pain rating scale
- visual analogue scale

6

Types of adjuvant pain medications

- TCAs
- Anticonvulsants

7

TCAs used in pain control

- amitryptyline
- Imipramine

8

Anticonvulsatns used in pain control

- carbamazepine
- valproic acid
- gabapentin
- pregabalin

9

MOA of paracetamol

Inhibitrs prostaglandin synthesis centrally

10

Cautions for paracetamol use

- overdose = liver failure (NAPQI = toxic)
- nephropathy with chronic use
- caution in renal and hepatic impairment

11

Classification of NSAIDs

- COX-1 selective
- Non-selective
- COX-2 selective

12

Contra-indications for NSAIDS

- hypersensitivity
- acute PUD

13

Cautions for NSAIDS

- renal and hepatic impairment
- dyspepsia
- cardiac failure
- hypertension
- bleeding disorders
- asthma

14

Features of selective COX-2 inhibitors

- less GI effects
- increased CVS risk
- needs to be taken with meals

15

Adverse effects of NSAIDS

- bronchoconstriction
- fluid retention
- nephropathy and ARF
- bleeding
- hypersensitivity
- dyspepsia and PUD
- hepatotoxicity

16

AE of opioids

- nausea
- sedation
- constipation
- respiratory depression

17

MOA of morphine

- affinity for u receptors
- histamine release

18

MOA of tramadol

- u receptor agonist
- inhibit seotonin and noradrenalin reuptake

19

Definition of chronic pain`

Pain lasting beyond the term of an injury or painful stimulus, present for more than 4-6 weeks

20

WHO pain relief ladder

- non-opioid
- weak opioids
- strong opioids

21

Cautions for morphine

- renal and hepatic impairment
- elderly
- pregnant
- lactation
- neonates
- decreased pulmonary reserve

22

Dose of morphine

10mg 4 hrly for 24 hours

23

Drug interactions with tramadol

- predisposes to serotonin syndrome when combined with SSRIs/ MAOIs
- metabolism induced by carbamazepine

24

Dose of tramadol

50mg 4-6 hrly, max 400mg/day

25

Dose of codeine

30-60mg 4-6 hrly

26

Describe variable metabolism of codeine

CYP2D6 variants
- slow metabolisers (poor analgesic effect, but constipation)
- rapid metabolisers (resp depression, coma and death)

27

Dose of amitryptyline

10-25mg nocte